February 20, 2020 was a long-awaited departure date after having previous trips to Haiti cancelled last year due to civil unrest. For Sheryl and I was our 6th trip to BLB and this time we brought along a graduate nursing student, Katie Englund who is finishing her master’s in nursing specializing in family practice. Our goals for the 5-day trip were to run two days of medical clinics, and have our third day dedicated to conducting an educational session focusing on pregnancy and infant food transitions.

When we conduct a clinic, it is free – this is important to note, as Grand Goave is a region where access to medical care is very difficult and hardly ever free. We are able to provide medicines and medical supplies as well as hygiene kits because of the support we receive through Health eVillages and Brother to Brothers Foundations.

The first clinic day was held at BLB. With many of our patients arriving long before our clinic started, we worked very hard to see all who came knowing it was often very difficult for the patients to get to BLB! We had an intake area where demographic information was gathered, and vital signs obtained. Demographics are much needed information so we can focus future educational initiatives on the needs of the community. Along with medical history, we asked about the patients living situation, access to food and water, employment and education levels. Haiti has very limited records of epidemiologic data and the community of Grand Goave has none, therefore gathering statistics is needed for future trip planning. Our goal and something we have been working on is to have a working electronic medical record so we can track progress. Thank you to Eileen Terry who worked very hard to get our data tracking system working, and Rae Stone for recording health information and help move patients to the clinic area. Thanks also go out to Madona obtained vital signs and translated, and Cherylann who worked tirelessly to hold every baby that entered the clinic!

Our waiting area at BLB

On the first clinic day we saw many young moms with their children. Their concerns ranged from viral symptoms to skin infections. We also saw many patients who came because they have never seen a medical provider. Reassuring patients that their physical exam result is normal is very rewarding. We also educated about hygiene, food and water intake as well as provided much needed vitamins, ointments and medicines.

A healthy 9-year-old with her 22-day old sister

A memorable patient worthy of sharing was a 19-year-old girl who presented with fever and a skin infection in her breast (mastitis). This commonly occurs while breastfeeding, but this was not the case for this girl. She was not breastfeeding, and she could not recall any breaks in her skin where bacteria could have entered. She had presented to another clinic two days before with a red, painful breast and they simply gave her Tylenol. Her symptoms worsened and by the time she came to BLB she had a fever with significant redness, and swelling in her breast. She could hardly bear the weight of her shirt touching her skin and was crying. She was unable to sleep, or really eat. She missed school as well as her day-to-day activities because of the pain. Sheryl provided her with much needed reassurance and gave her antibiotics and analgesics with education on her condition and the importance of presenting back if symptoms didn’t resolve, worsened or recurred. She was told to follow up in 48 hours (picture below), which she did with noteworthy improvements; she was afebrile, and the infection resolving. She was so grateful that she gave Sheryl a big hug and spoke a few words - The translator responded, “she said you gave her hope”.

Day 2 brought us to a clinic off site in a mountainous area of Grand Goave – access is very limited as transportation down the mountain is nearly impossible. We worked collaboratively with two Haitian physicians, sharing supplies and medications. Between the 4 of us we saw over 150 patients. The majority of these patients suffered from severe skin infections, fungal, bacterial and parasitic. This is a frustrating reality of Haiti where much of the population lives in “shelters” that do not protect them from the harsh weather patterns. We were able to provide ointments and antifungals and antibiotics where needed, and more importantly offered education on hygiene, using natural resources to rid of symptoms. Dermatologic conditions are a topic that we plan to develop education resources for future trips.

On our final day we were able to conduct an educational session for women and children. Sheryl and I have been working on this for well over a year on healthcare topics we identified from our last clinic at BLB. Our topics centered on pregnancy and breastfeeding and included food sources rich in iron and folic acid, healthy physiologic changes in pregnancy and warning signs in pregnancy. We provided education resources in many formats to include translated videos and handouts with many visual components for reference. We also discussed breastfeeding transition to solid foods with a translated video presentation and handouts. All handouts included pictures and were laminated in heavy cardstock so they would last. Mirlaine served as the presenter and was fantastic in conveying her knowledge on all topics. She did an excellent job presenting the material to all who attended, and we hope she will continue using the information to continue to educate those who need it. We ended the presentation with snacks, drinks and for those who were pregnant we did a prenatal visit where we could listen to the baby’s heartbeat with doppler technology provided by Health eVillages.

Our education session attendees at BLB

Women watching a video on foods rich in iron

Katie (NP student) doing a heartbeat check

The success of our clinic could not have happened without the help of our interpreters Madona and Mirlaine. They were professional and attentive in translating for us. They always help us understand cultural issues that impact the health of the people of Grand Goave and provide us the opportunity to communicate with our patients. We were also able to collect a tremendous amount of data on all who came to the clinic. This will help us track usage as well as guide us on future health initiatives for the clinic and community. Thank you Cherylann, Eileen and Rae for all your work to capture this important information. We will continue to work with developers so we can use an app to capture this data.

Mirlaine, BLB’s live-in nurse has been with us since the onset of our clinic time in Haiti. We are so appreciative of her time educating us on health issues in Haiti and we would never be as successful and efficient with our time if it wasn’t for her. She is a valuable resource and an excellent nurse. A joy to collaborate with!

Mirlaine using one of the education tablets provided by Health eVillages

Our last thank you goes to Be Like Brit, Regis College and Health eVillages for giving us the chance to do what we do best. Each time we are here we can feel the impact and we can see the trust we are gaining in the community.

Lisa getting a kiss from one of her patients

Sheryl with a baby needing a physical exam at BLB clinic

We can’t wait to go back!

Sheryl Kelleher - FNP

Lisa Krikorian – FNP, WHNP

Katie Englund – FNP student